MEDICARE: COURTNEY JEAN PATE MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1275483307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY JEAN PATE MS

Provider Business Mailing Address
First Line	:	1580 N FIESTA BLVD STE 200
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85233-1032
Country	:	US
Telephone Number	:	480-542-9992
Fax Number	:

Provider Business Practice Location Address
First Line	:	1580 N FIESTA BLVD STE 200
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85233-1032
Country	:	US
Telephone Number	:	480-542-9992
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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Directions to “ COURTNEY JEAN PATE MS” Practice Location

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